Archive for January, 2008

For those of you who haven’t been keeping up with the skeptics circle, #78 is now up over at The Skeptical Surfer. The skeptics circle is a good way to learn about skeptical blogs and catch the flavor of the various bloggers out there. So click on over. There are two submissions from our new Science Based Medicine blog, and plenty of more skepticism on a variety of topics.

My favorite creationist neurosurgeon, Dr. Michael Egnor, has written a rebuttal to my previous post criticizing the dualism of Deepak Chopra. His rebuttal is very revealing about the disconnect between dualists – those who think that the mind is something more than and separate from the brain, and materialist neuroscientists – those who think that the functioning of the brain is an adequate explanation for the phenomenon of mind. Egnor illustrates, although it seems inadvertently, that the real difference is that between science and philosophy.

In my original post I stated:

Deepak then plays the “false controversy” gambit. He wants us to keep an open mind “until the argument is resolved.” But there is actually nothing left unresolved. Deepak has presented no mysteries that cannot comfortably be explained within the completely material paradigm of neuroscience. His “invisible will” is nothing more than a trick of semantics – not an established phenomenon; not a genuine mystery to be solved. He says the material paradigm is “untenable” but has presented nothing that makes it so.

To which Dr. Egnor responds:

Is there genuinely “nothing left unresolved’ in our understanding of the mind-body problem? Are there “no mysteries that cannot comfortably be explained within the completely material paradigm of neuroscience?” The truth is that there remain enormous mysteries, and virtually nothing about these mysteries is resolved. The mind-body problem is perhaps the most active and contentious area of modern philosophy, and there is very little “resolved”. Of the many issues raised by philosophers, perhaps the most important is the “hard problem of consciousness” formulated by philosopher David Chalmers.

The story of a man who regained his vision after a chiropractic manipulation has been circulating around the internet, causing anyone with the slightest knowledge of human anatomy and appreciation for the truth to cringe. Here are the facts of the story, as related by the media. Doug Harkey went suddenly blind in his left eye 12 years ago. Recently, after a “routine visit” to his chiropractor, Tim Stackis, in which he received neck manipulation, Harkey noticed that his eyes were watering, first his left eye then his right eye. While wiping his right eye, and therefore occluding it, he noticed that he could see out of his left eye.

Doctor Stackis reports that he manipulated the bones in Harkey’s neck because they were out of alignment, adding:

“That interferes with the messages and energy the brain sends down to the rest of the body.”

In response to my blog entry from yesterday, When Quacks Were Quacks, nfpendleton wrote: “When will we see the advertisement with the doctor who recommends Charlestons because they’re a ‘cleaner, healthier’ smoke?” While this question is a non sequitur, having nothing to do with the original post (I specifically distanced myself from any nostalgia for my colleagues of the past), it did inspire me to delve deeper into the changing attitudes over health care and doctors in the last half century.

It is true that up through the 1950 doctors were not generally warning against smoking, and some doctors were even shills for the tobacco industry. Orac has already collected a number of videos from the 1940′s and 1950′s showing how much attitudes toward smoking has changed. Included is one in which a physician is asked, “what brand of cigarrettes do you smoke, doctor?” Of course I cringe at all these advertisements, but especially the scene of a doctor smoking and recommending his favorite brand.

Here is an interesting anecdote – my grandmother told me that she started smoking in the 1930′s on the advice of her physician, who told her it would calm her nerves (she had just lost a her one year old daughter to pneumonia).

Take a look at this educational video from 1959 (and thanks to Jeff Jones for sending me this link). The film is wonderfully campy – a perfect example of the genre from the 1950′s. I love these glimpses at history. They take us out of our narrow temporal perspective, the snap shot of time in which we currently exist, and provide a useful perspective on where we have been as a guide to where we are. I have a few observations.

The video shows that almost 50 years ago, a half a century, cure-all scams were no different than the ones we have around today. The script hasn’t changed – natural remedies from an exotic part of the world being sold with astounding anecdotes. They also mention that testimonials are worthless – they can be easily faked, and even when sincere they represent nothing but wishful thinking, even by those who later died of the illness of which they claimed they were cured.

My blog entry today for Science-Based Medicine reviews a new study claiming to provide evidence for the healing power of magnets. I want to pick up on a theme I just touched upon in that article and extend it a bit – the relationship between pre-clinical and clinical evidence and their proper use in making and marketing health claims.

One of the biggest problems with the current supplement industry is that there is a significant disconnect between the scientific evidence and the claims made for specific products. Under the Dietary Supplement Health and Education Act of 1994 (DSHEA), in the US herbs, supplements, and other health products can make health claims in their marketing and literature without FDA approval or oversight, as long as those claims do not involve the treatment of a specific disease. A new category of health claims was invented for DSHEA – so-called structure/function claims: sellers can claim that a product supports or improves a biological function or structure. Therefore companies may claim that St. John’s Wort improves mood (a function), but they cannot say it treats depression (a disease).

I have been following the story of claims that thimerosal in childhood vaccines causes autism for a few years, and writing about it often in this blog. Without putting too fine a point on it, there are two camps when it comes to the question of the relationship between thimerosal and autism. The first camp (of which I am a member) has looked at all the scientific evidence and has come to the conclusion that thimerosal does not cause nor contribute to autism, that vaccines in general do not cause autism, and that there is no autism epidemic (as is often claimed), but rather an increase in surveillance and expansion of the diagnosis. This camp includes almost the entire scientific and medical communities.

The other camp appears to be motivated by ideology, not science. They cherry pick and misinterpret the scientific evidence systematically to support their beliefs, but the science is against them. They are comprised of misguided journalists, ignorant celebrities, well-meaning but scientifically naive parents, dedicated ideological groups including those who are anti-vaccine, conspiracy-mongering activists, and a few incompetent scientists.

A recently published study uses functional MRI to look as brain function in response to possible extra-sensory perception (ESP) stimuli. The study was negative, leading the authors to conclude:

These findings are the strongest evidenceyet obtained against the existence of paranormal mental phenomena.

While that might be overstating it a bit, it was an interesting new approach to the question of ESP. Study authors, Samuel Moulton, a graduate student in the department of psychology at Harvard University, and Stephen Kosslyn, also at Harvard, decided to look for ESP in the brain by imaging subjects with fMRI during ESP and non-ESP signals. The ESP signals consisted in one trial of an emotionally close person looking at the target image and attempting to telepathically send the image to the subject, who was also looking at the image. A second trial involved a computer screen in another room with the target image (testing clairvoyance). And a third trial involved displaying the image to the subject again after the trial (testing precognition).

OK, not directly. This is more of a manifestation of the law of unintended consequences. Here is the chain of events:

Concerns over man-made global warming have increased awareness of the need for energy conservation. This in turn has led to the popularity of compact fluorescent bulbs (CFB’s) as replacement for the old incandescent bulbs. (CFB’s use 75% less energy for the same light output, as they generate less waste heat). Governments, wanting to seem proactive in tackling the high-profile problem of global warming, are beginning to pass laws requiring the phasing out of incandescent bulbs in favor of the new fangled CFB’s. This will save money, energy, and atmospheric carbon. So far so good.

In response to my blog entry yesterday I was sent the following comment:

Dear Dr. Novella,
After reading your blog post on drugs vs. herbs I would like to ask you what your opinion of “adequate scientific evidence” is. I feel less confident with current drug development than throwing a couple of plants that people have been using for thousands of years (how is that for sample size?) in some water than I do trying certain medications.
Allow me to explain. As a scientist I dabbled in a couple of fields before specializing in genomics. One of them was clinical trials for 3 different drugs for ALS. We were the national headquarters so I was privy to data from the whole country. NOT ONE adverse event was attributed to the drugs. I find that hard to believe. I am aware of the implications of ALS as a disease but the symptoms reported were not congruent with that. I also understand the pressure of fellowships, the massive amount of time and money it takes to push a drug through, and the fact that the majority of subjects of clinical trials do not reflect all of the populations the drug is intended for.
I am not forsaking drugs for herbs. I don’t understand why it has to be one or the other. Both sides have instances where public safety is not at the forefront. Herbal companies that treat herbs like drugs (isolating compounds, capsulizing them) can be dangerous and be just as greedy for money. Herbs used in a traditional sense taught by generations can be effective. Just because natives haven’t put their medicine through your process of scientific inquiry does not necessarily mean they are ineffective. The traditional way these herbs are used by definition would not be easily recorded or accurately analyzed by clinical trials.
Plant based pharmaceuticals are rarely in the dosage found in nature. Also, because only certain compounds are isolated (often alkaloids) the chemicals are not working in the same manner as they would in the plant. Plants do have nutritional value, by the way. Ever eat a salad? How about the calcium, iron and other vitamins in Nettles?
Thanks for reading,
Michele